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Single Arch Dentures: Upper Clinical Instructions


Clinical Instructions:

Single Arch Upper Dentures

AvaDent™ Clinical Instructions Welcome to the new standard of care in removable prosthetics, AvaDent™ Digital Dentures. Developed by an international team of leaders in the digital dentistry field, AvaDent’s breakthrough technology brings the precision, aesthetics, speed and profitability of CAD/CAM process automation to removable dentistry. AvaDent™ Digital Dentures, whose name is derived from Ava meaning rebirth and Dent meaning dentition, make it possible for you to offer your patients a precise fitting, aesthetic denture in as little as two appointments. Additionally, AvaDent™ allows you to offer the digital denture using standard clinical procedures, with no computer skills or capital investment required. Increase your profitability and patient satisfaction with the one removable prosthetic that is virtually changing dentures forever ... AvaDent™.

AvaDent™ Materials 1. Thermoplastic Trays and Case with Caliper 2. AvaDent Anatomical Measuring Devices (AMD): A. Upper Tray with vertical height pin and lip support B. Vertical height pin extension C. Lower Single Arch Tray D. Lower Tracing Tray 3. AvaDent Putty (Base and Catalyst) 4. AvaDent Border Molding Material 5. AvaDent Bite Registration Material 6. AvaDent Impression Material 7. AvaDent Adhesive 8. AvaDent Adjustment Tool 9. Aesthetic Tooth Guide Transparencies 10. AvaDent Caliper 11. AvaDent Bite Plane 12. AvaDent Prescription Forms 13. Plastic Case Bags 14. AvaDent Cup 15. AvaDent Thermometer 16. AvaDent Case Shipping Box

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17. AvaDent Start-up Kit Case 18. AvaDent Clinical Instruction Manuals 19. AvaDent Clinical Procedure DVD 20. AvaDent Chair-side Guide 21. AvaDent Patient Marketing Materials CD 22. AvaDent Counter Card and Holder

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By Global Dental Science LLC

AvaDent™ Impression Procedure for Upper Single Arch Follow the procedure in the AvaDent Clinical Instruction Manual for a maxillary final impression of an edentulous patient. There is no lower impression necessary; the lower dentition will be recorded in the AMD record.

AvaDent™ Anatomical Measurement Device (AMD) Procedure for Upper Single Arch Use the Upper AMD tray and Mandibular AMD Single Arch Dentition Tray for this procedure. When creating your Single Arch Upper AMD it is important to understand that not all Single Arch cases will present with sufficient vertical to satisfy ideal OVD, anterior aesthetics and anterior vertical overlap. The need to comprise one of these parameters may be necessary for clinical and/or patient acceptance. To ensure the success of your AvaDent make sure you have captured and verified the correct incisal edge and have achieved appropriate anterior vertical overlap. The resultant OVD will be accommodated into these measurements. If you anticipate or discover that your patient presents with a reduced OVD, the AMD will be created without a lower tray and the Gothic Arch Tracing option as described and you will complete the AMD as described in step 5.

1. Have the patient sit in an upright and relaxed position with their head unsupported. With the existing dentures in the mouth, place a dot on the tip of the patient’s nose (or below the patient’s nose if you choose) and chin. Measure this distance with the AvaDent Caliper, and then put the Caliper aside. Note: If the patient presents without dentures, place a dot on the tip of the patient’s nose (or below the patient’s nose if you choose) and chin and establish Vertical Dimension at Rest (VDR). This is done by asking the patient to say the letter “M” three times and relaxing the jaw. Record the measurement using the AvaDent Caliper and subtract 3mm from this measurement to establish the approximate OVD.

2. Remove the existing dentures from the patient’s mouth and choose the correct size AMD using the caliper to measure the widest part of the patient’s ridge. If the ridge is between AMD sizes, choose the smaller AMD size.

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© 2013 Global Dental Science, LLC. AvaDent is a registered trademark of Global Dental Science, LLC.


Clinical Instructions:

Single Arch Upper Dentures

3. Place the upper and lower AMD trays in the mouth separately. Visually inspect that each tray fits properly over the ridge. While you hold the tray in place have the patient move his or her jaw from side to side and open and close. If the tray moves or causes discomfort, trim the tray so it fits comfortably. Remove trays. Note: You can also place the AMD on the Poly Vinyl Siloxane model you created for the impression tray to see the fit. Soften the AMD with a flame and contour it the ridge of the model if necessary.

4. Coat the Mandibular AMD Single Arch Dentition Tray with adhesive and fill the posterior part of the tray only with AvaDent Bite Registration Material. Firmly place the tray in the posterior on the lower dentition, leaving the anterior teeth exposed. Once polymerized, remove the tray. Note: In a case where posterior teeth are missing, stabilize the Mandibular AMD Single Arch Dentition Tray by expressing ample AvaDent Bite Registration Material onto the tissue side of the tray and holding it in the proper horizontal position until polymerized.

5. Coat the AMD Maxillary Tray with AvaDent Tray Adhesive. Express an ample bead of AvaDent Border Molding Material inside the ridge area of the tray, and then cover the palate with additional material to ensure stability. Seat the AMD tray over the edentulous ridge while aligning the lip support parallel to the inner pupillary line.

Remember: Use adequate material to secure the tray onto the ridge. This aids in obtaining the correct CR.

Remember: Capture the complete anatomy of the ridge. This ensures accurate correlation of the AMD and the final upper impression.

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By Global Dental Science LLC

Remember: Ensure lip support does not interfere with lower tracing tray, adjust or trim if necessary. Tip: Trim excess material from maxillary tray which may cause un-natural contour of facial features. With lip support correctly positioned, the lips should now close around AMD trays comfortably and AMD should not be discernible when in patient’s mouth. Remember: Ensure trays are parallel to one another, without interference, trim tray if necessary.

a. If the trays are touching and you are unable to achieve the desired OVD, the following procedure is indicated: • Remove the Mandibular AMD Tray: you will not use the lower tracing tray from this point forward.

• With the upper tray seated, rehearse putting the patient in CR by manipulating the mandible into CR and close to the pre-determined OVD.

• Have the patient open, then express AvaDent Bite Registration Material onto the lingual side of the upper tray in the posterior region only, leaving the lower anterior teeth exposed.

• Manipulate patient back into the correct OVD and CR position. Hold patient in this position to allow material to polymerize. (Ignore CR Tracing step #9-13)

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© 2013 Global Dental Science, LLC. AvaDent is a registered trademark of Global Dental Science, LLC.


Clinical Instructions:

Single Arch Upper Dentures

6. Establish OVD: With the patient’s lips closed, have the patient gently bite down so the center-baring pin rests on the tracing table of the Mandibular AMD Single Arch Dentition Tray. Use your AvaDent Adjustment Tool to raise or lower the OVD to your predetermined measurement. Clockwise to increase OVD; counterclockwise to decrease OVD. Use your AvaDent Caliper to confirm OVD. Note: The relationship between OVD and the Aesthetic Zone is critical in this procedure. You can not increase or decrease OVD without affecting the overall aesthetic outcome. Check to see if the bottom edge of the lip support overlaps the incisal edge of the lower anterior teeth. This will be true in the majority of cases. If not, you will want to re-check your OVD. Further refinement of the maxillary incisal edge will occur with the application of the Aesthetic Guide Transparency (step #16). Note: you may need to trim the incisal edge of the Lip Support if it interferes with the lower teeth or lower tray.

7. Mid-line: Using a thin permanent marking pen, establish the patient’s mid-line by placing a mark on the lip support.

8. Incisal Edge: Using a thin permanent marking pen, record the patient’s desired maxillary incisal edge on the lip support. Make this mark the entire length of the lip support. Note that the maxillary incisal edge should overlap the mandibular incisal edge in most cases.

9. Remove the lip support from the AMD.

Clinical_Instructions_SA_UD_v.2

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By Global Dental Science LLC

10. Establish Centric Relation (CR)/Gothic Arch Tracing: Guide the mandible into CR and have the patient move jaw forward and backward, then left then right. This causes the pin to mark the mandibular tracing table of the Mandibular AMD Single Arch Dentition Tray creating a gothic arch tracing. The apex of the arrow point tracing represents CR. (If you would like to create a stronger visual put occlusal spray on the tracing table.)

11. Remove the lower tray and create a divot at the apex of the arrow using a round bur. Note: Optional methods of marking include occlusal spray and bite registration paper.

12. With both trays in the mouth have the patient bite down so that the ball of the pin rests in the divot, confirming CR. Reaffirm the OVD, making any necessary adjustment to account for the depth of the divot.

13. Replace the lip support.

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Š 2013 Global Dental Science, LLC. AvaDent is a registered trademark of Global Dental Science, LLC.


Clinical Instructions:

Single Arch Upper Dentures

14. Upper Lip contour: Using the AvaDent Adjustment Tool, establish the patient’s proper lip contour and overjet by adjusting the lip support in or out.

15. Horizontal Plane: With the patient in front of you, insert the AvaDent Horizontal Plane into the upper AMD. Establish a parallel line between the inner pupillary line of the patient’s eyes and the blue line of the Horizontal Plane. Adjust the Horizontal plane accordingly and record number on the prescription form. A normal value is between 8 and 12. Remove the bite plane.

16. Aesthetic Guide: The size of the denture teeth is determined by placing the three Aesthetic Guides over the teeth in the patient’s existing denture to determine which size approximates the existing teeth. This process assumes the patient has indicated that he or she likes the size of the teeth. The position of the pink denture base resin around the necks of the denture teeth is also identified using the Aesthetic Guide by selecting 1, 2 or 3 for the gingival height. The teeth can also be selected from a mold guide in the usual manner. The shade is selected from the shade guide. Note: If the patient does not have a denture, choose the guide that gives you an appropriate aesthetic result.

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By Global Dental Science LLC

17. Place flowable light cure composite on the back of the Guide. Ensure Lip Support is dry to aid in adhesion. Place the guide to the desired position using your incisal and midline marks. If the incisal edge is below the edge of the Lip Support, position the Aesthetic Guide in the correct position in relation to the incisal edge of the lower teeth and affix to Lip Support with a curing light. Tip: An alternative method would be to remove the AMD and attach the transparency using cyanoacrylate adhesive. Align the transparency with midline and incisal edge indicated on lip support. marks. After adhesive has dried, insert and verify esthetics. Remove and repeat previous step if necessary.

18. Have the patient smile broadly and use the Aesthetic Guide to confirm the appropriate cervical height and record it on the prescription.

19. Stabilizing the AMD: While the patient is locked into CR, use a large tip to liberally inject AvaDent Bite Registration Material between the maxillary and mandibular AMD trays from each side in the pre-molar area, until the material begins to flow out of the cheeks. Ensure the material passes all the way into the center of the trays near the central bearing pin. Prior to polymerization, massage the cheeks to mold the material, which helps define the buccal corridor area. Note: You may indicate the vertical plane of the occlusion by penciling a line in the buccal region of the completed AMD.

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Š 2013 Global Dental Science, LLC. AvaDent is a registered trademark of Global Dental Science, LLC.


Clinical Instructions:

Single Arch Upper Dentures

20. Recording Lower Occlusion: Remove the AMD and place a light bead of impression material on the posterior portion of the lower tray and a heavier bead on the anterior and place it back in the mouth. The purpose of this is to capture a full impression, making sure that the full anatomy of the anterior teeth is recorded. Note: If you have chosen the optional technique due to reduced OVD, remove upper AMD, place a light bead of impression material on the lingual side of the tray and a heavier bead on the anterior and place back in the mouth.

21. Verify the aesthetics of your AMD by taking photographs of your patient at rest and smiling.

22. Choose appropriate tooth shade.

23. Remove the AMD from the mouth. Your Single Arch Upper AMD is complete. Clincal Alert: Examine completed AMD and ensure excess impression material and tray material have been removed from maxillary and mandibular (if used) trays which may cause un-natural contour of facial features. With lip support correctly positioned, the lips should now close around AMD trays comfortably and AMD should not be discernible when in patient’s mouth. While the patient is at rest and smiling, observe proper OVD, lip contour, amount of tooth display and midline. Ensure you display the appropriate aesthetics and have achieve proper vertical overlap of anterior teeth. If you have not met these requirements visually, you AMD may not be correct. Make corrections if necessary.

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By Global Dental Science LLC

24. Complete the AvaDent Prescription Form.

25. Disinfect the AMD. Ship the AvaDent Prescription along with the AMD and impressions to Global Dental Science.

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Š 2013 Global Dental Science, LLC. AvaDent is a registered trademark of Global Dental Science, LLC.

AvaDent - Single Arch - Clinical Instructions  

AvaDent Digital Dentures zijn ook beschikbaar voor casussen met enkele een boven- of onderkaak

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